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  • 1
    Electronic Resource
    Electronic Resource
    Inter- and intraobserver reproducibility in radiographic diagnosis and classification of femoral trochlear dysplasia (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 285-289 
    Details
    ISSN: 1279-8517
    Keywords: Knee ; Trochlear dysplasia ; Patellofemoral instability ; Radiographic assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les critères radiographiques de Dejour sont utilisés couramment pour diagnostiquer et apprécier la dysplasie de la surface patellaire (trochlée) du fémur en cas d'instabilité fémoro-patellaire. Le but de ce travail était d'étudier la fiabilité intra- et inter-observateur de ces critères radiographiques. 68 radiographies de profil strict de genoux ont été examinées indépendamment par 7 observateurs (2 juniors et 5 seniors) pour apprécier l'accord inter-observateur, et les deux juniors ont répété leurs observations pour apprécier l'accord intra-observateur. Ces 68 radiographies de profil vrai de genoux provenaient des dossiers de 64 patients qui avaient subi une trochléoplastie pour instabilité fémoro-patellaire. Pour évaluer l'accord sur les données catégorielles (type morphologique de la trochlée), nous avons utilisé le test Kappa ; pour les données numériques (profondeur et saillie de la gorge de la trochlée), nous avons utilisé l'analyse de corrélation interclasse. Le signe du croisement (entre la gorge de la trochlée et la limite antérieure des deux versants de la trochlée) était fiable puisque la probabilité de classer “normale” une trochlée pathologique était seulement de 3,1 % (0 à 8,8 %). Pour classer la morphologie de la trochlée, l'accord inter-observateur était modéré (Kappa=0,17) et l'accord intraobservateur était faible (Kappa=0,3). Par ailleurs, la mesure de la profondeur et de la saillie de la gorge de la trochlée était plus fiable puisque les coefficients de corrélation interclasse entre observateurs étaient respectivement de 0,62 et 0,38. L'erreur la plus fréquente commise entre les observateurs concernait le diagnostic des dysplasies de type II. Pour clarifier les critères de Dejour, nous proposons de ne retenir le diagnostic de dysplasie de type II que lorsqu'il existe au moins 5 mm entre les points de croisement respectifs des versants médial et latéral de la trochlée avec la gorge de la trochlée. Nous recommandons d'utiliser la saillie de la gorge de la trochlée pour évaluer le grade de la dysplasie de la trochlée osseuse.
    Notes: Summary Dejour's radiographic criteria are commonly used to diagnose and assess femoral trochlear dysplasia in case of patello-femoral instability. The aim of this study was to establish the intra- and interobserver reliability of these radiographic criteria. Sixty-eight lateral knee radiographs were examined independently by 7 observers (2 juniors, 5 seniors) to assess interobserver agreement, and the 2 juniors repeated the observations to test intraobserver agreement. These 68 true lateral views were harvested from clinical records of 64 patients who underwent a trochleoplasty because of patellofemoral instability. To evaluate the agreement on analytic data (morphologic type of trochlea) we used the kappa statistical method, and to evaluate the agreement on numerical data (depth and prominence of the trochlear groove) we used interclass correlation analysis. The “crossing sign” (between the trochear groove and the anterior aspect of both condyles) was reliable since the probability of rating as normal a pathologic trochlea was only 3.1% (0 to 8.8%). In classifying trochlear morphology interobserver agreement was slight (kappa=0.17) and intraobserver agreement was fair (kappa=0.3). On the other hand, the measurements of the depth and prominence of the trochlear groove were more reliable since the interclass coefficients between observers were 0.62 and 0.38 respectively. The most frequent interobserver error was related to misdiagnosis of type II. To clarify Dejour's criteria we propose a diagnosis of type II only when 5 mm or more are measured between the intersections with the medial and lateral femoral condyles. We recommand the use of the prominence of the trochlear groove to evaluate the grade of bony trochlear dysplasia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01628492
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  • 2
    Electronic Resource
    Electronic Resource
    Inter- and intraobserver reproducibility in radiographic diagnosis and classification of femoral trochlear dysplasia (1998)
    Springer
    Surgical and radiologic anatomy 20 (1998), S. 285-289 
    Details
    ISSN: 1279-8517
    Keywords: Knee ; Trochlear dysplasia ; Patellofemoral instability ; Radiographic assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Dejour’s radiographic criteria are commonly used to diagnose and assess femoral trochlear dysplasia in case of patello-femoral instability. The aim of this study was to establish the intra- and interobserver reliability of these radiographic criteria. Sixty-eight lateral knee radiographs were examined independently by 7 observers (2 juniors, 5 seniors) to assess interobserver agreement, and the 2 juniors repeated the observations to test intraobserver agreement. These 68 true lateral views were harvested from clinical records of 64 patients who underwent a trochleoplasty because of patellofemoral instability. To evaluate the agreement on analytic data (morphologic type of trochlea) we used the kappa statistical method, and to evaluate the agreement on numerical data (depth and prominence of the trochlear groove) we used interclass correlation analysis. The “crossing sign” (between the trochear groove and the anterior aspect of both condyles) was reliable since the probability of rating as normal a pathologic trochlea was only 3.1% (0 to 8.8%). In classifying trochlear morphology interobserver agreement was slight (kappa = 0.17) and intraobserver agreement was fair (kappa = 0.3). On the other hand, the measurements of the depth and prominence of the trochlear groove were more reliable since the interclass coefficients between observers were 0.62 and 0.38 respectively. The most frequent interobserver error was related to misdiagnosis of type II. To clarify Dejour’s criteria we propose a diagnosis of type II only when 5 mm or more are measured betweeen the intersections with the medial and lateral femoral condyles. We recommand the use of the prominence of the trochlear groove to evaluate the grade of bony trochlear dysplasia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-998-0285-x
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  • 3
    Electronic Resource
    Electronic Resource
    Common Features on Damage Mechanisms Identified on Various Metal and Ceramic on Polyethylene Articulating Surfaces of Total Hip Prostheses (2007)
    s.l. ; Stafa-Zurich, Switzerland
    Materials science forum Vol. 539-543 (Mar. 2007), p. 629-634 
    Details
    ISSN: 1662-9752
    Source: Scientific.Net: Materials Science & Technology / Trans Tech Publications Archiv 1984-2008
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Notes: This paper presents a methodology for assessing the in-vivo degradation mechanisms ofarticular components of total hip replacement (THR) prostheses of Charnley type. The experimentalprocedure revealed that common features can be observed even if the clinical cases underinvestigation were quite different with regard to the demographic data. It particularly emphasisesthe detrimental effects of foreign bodies on the damage of the articulating surfaces. These foreignbodies can migrate into the joint space before embedding definitely into the Ultra High MolecularWeight Polyethylene (UHMWPE) acetabular cup surface where they further participate to a thirdbody wear mechanism accelerated by a progressive increase of the femoral head roughness.Our experimental results underline, from a practical point of view, the need for carefulmanufacturing and clinical handling of porous surfaces, advocate for a systematic assessment ofretrieved components, particularly when changed because of unexplained wear, and makequestionable the clinical use of multifilament trochanteric cables
    Type of Medium: Electronic Resource
    URL: http://www.tib-hannover.de/fulltexts/2011/0528/02/14/transtech_doi~10.4028%252Fwww.scientific.net%252FMSF.539-543.629.pdf
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  • 4
    Electronic Resource
    Electronic Resource
    Le cadre de Hartshill-Dove en traumatologie : à propos du traitement de 40 fractures thoraciques et lombaires (1991)
    Springer
    European journal of orthopaedic surgery & traumatology 1 (1991), S. 239-245 
    Details
    ISSN: 1432-1068
    Keywords: Spine fractures ; Surgery ; Hartshill-Dove rectangle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Forty thoracolumbar fractures, including thirty-two with neurological complications, were stabilized with the Hartshill-Dove rectangle. Its configuration explains its better rigidity compared to two separated Luque rodes. With this device one can only neutralise the reduction, without compression or distraction. When neurological signs exist, we performed a wide laminectomy or a posterolateral decompression before the osteosynthesis. We can contour the rectangle with whatever profile we desire. Double wires were the only way of fixing the rectangle. The number of stabilized levels depends on: the site of lesion: seven levels fixed in the thoracic spine and four to five in the lumbar spine, the type of fracture: more levels were instrumented for translation or compression-distraction fractures than for compression ones. Posterolateral graft is extended only one level above and one down the fracture. Local and regional kyphosis was corrected by more than fifty per cent. Translation were perfectly corrected 16 out of 19 times. We had only one neurological complication which was due to a postoperative epidural hematoma and not to the manipulation of the wires. The main ways to avoid iatrogenic complications are to operate under medullary monitoring, to perform wide windows on neural arches and to manipulate wires with high precision. The best indication for this very simple device are: on thoracic spine: all fractures with neurological deficit. If there is no neurological trouble: translations, contiguous lesions, vertebral kyphosis over 30° and the association with a sternal fracture; on lumbar spine: translation and compression-distraction fractures. With the compression fractures we prefer to adopt pedicular screwing or anterior arthrodesis.
    Notes: Résumé Quarante fractures thoracolombaires, la plupart compliquées de troubles neurologiques (32), ont été ostéosynthésées par cadre de Hartshill-Dove. La configuration de ce cadre explique une plus grande rigidité que deux tiges séparées de Luque. Avec ce type de matériel, on ne peut faire que des montages en neutralisation, sans possibilité de compression ni de distraction. Quand il y a trouble neurologique, une large laminectomie, voire une décompression postéro-latérale, précède l'ostéosynthèse. On donne au cadre le galbe de profil désiré; les fils doubles ont été les seuls moyens d'instrumentation utilisés; le nombre de niveaux instrumentés dépend : du segment opéré (7 niveaux en thoracique contre 4 ou 5 en lombaire) et du type de lésion (plus de segments instrumentés pour les translations ou les compressions-distractions que pour les compressions pures). La greffe postérolatérale ne sera localisée qu'en regard de la fracture. Les cyphoses locales et régionales sont corrigées de plus de 50 %; les translations sont corrigées 16 fois/19. Une seule aggravation neurologique est notée dans la série : elle n'est pas due au passage des fils mais à un hématorachis secondaire. Pour éviter les lésions neurologiques iatrogènes, il faut opérer sous monitorage médullaire, réaliser de larges fenêtres et passer les fils métalliques selon les principes techniques décrits. Les meilleures indications de ce matériel très simple d'utilisation sont : en thoracique : toutes les fractures compliquées de troubles neurologiques; s'il n'y a pas de trouble neurologique, les translations, les lésions étagées, les cyphoses vertébrales supérieures à 30°, l'association à une fracture du sternum sont les meilleures indications. En lombaire : les translations et les compressions-distractions. Dans les compressions pures, il faut associer un vissage pédiculaire ou un temps d'arthrodèse antérieure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01752799
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  • 5
    Electronic Resource
    Electronic Resource
    The long-term results of tibial tubercle transfer for patellar instability (1997)
    Springer
    European journal of orthopaedic surgery & traumatology 7 (1997), S. 33-36 
    Details
    ISSN: 1432-1068
    Keywords: Tuberosité tibiale ; Instabilité rotulienne ; Transposition ; Tibial tubercle ; Patellar instability ; Transfer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs rapportent les résultats d'une série de 57 transpositions de la tubérosité tibiale antérieure réalisées sur 46 patients (32 femmes) entre 1974 et 1984. Sur 95 transpositions recensées pour traitement des instabilités rotuliennes objectives et potentielles, 57 ont été revues avec un recul moyen de 14,9 ans. Notre taux de révision est de 60%. A la révision 19,3% des patients ont vu disparaître totalement les douleurs. Nous n'avons pas constaté de récidive de luxation de la rotule, 49,2% des patients étaient satisfaits de l'intervention sur les accidents d'instabilité. L'arthrose fémoro-tibiale interne débutante était retrouvée dans 5 cas, dans 2 cas il existait un pincement complet de l'interligne et dans 1 cas un pincement complet de l'interligne fémoro-patellaire interne. La révision des patients ne permet pas de préjuger du rôle néfaste de la transposition de la TTA sur les compartiments fémoro-patellaires et fémoro-tibiaux interne. Nous estimons que les effets secondaires rapportés sont plus liés au non-respect des contre-indications que sont pour nous le genu varum, la ménisectomie interne et la transposition sur TA-GT normale que la transposition elle même. Les auteurs estiment que la transposition de la TTA garde des indications, dans le traitement des instabilités rotuliennes objectives et potentielles si la symptomatologie est dominée par les instabilités et les luxations de la rotule et si la mesure de la TA-GT est augmentée (〉 20 mm).
    Notes: Abstract The authors report results of a series of 57 tibial tubercle transfers in 46 patients between 1974 and 1984. Of 95 patients operated on for objective and potential patellar instability, 57 (67%) were reviewed with an average follow-up of 14.9 years. At follow-up 19.3% were free of pain. There were no recurrent patellar subluxations and 49.2% of patients were satisfied with the operation as regards episodes of instability. Early medial tibio-femoral arthritis was found in 5 cases. In two there was complete loss of the joint line and in one case complete loss of the medial patellofemoral joint line. Follow-up did not allow us to make an assessment of the adverse role of the tibial tubercle transfer on the patello-femoral and medial tibio-femoral compartment. We consider that the secondary effects are due to a failure to respect the contraindications, which for us were genu varum, previous medial meniscectomy and transfer with a normal tuberosity/trochlea offset rather than due to the transfer itself. The authors believe that tibial tubercle transfer is still indicated in the treatment of objective and potential patellar instability if the symptomatology is dominated by instability and dislocation of the patella and if the tuberosity/trochlea offset is greater than 20 mm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00578830
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  • 6
    Electronic Resource
    Electronic Resource
    Influence of a foreign body on the wear of metallic femoral heads and polyethylene acetabular cups of total hip prostheses (2000)
    Springer
    Journal of materials science 35 (2000), S. 4583-4588 
    Details
    ISSN: 1573-4803
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Notes: Abstract Excessive wear of polyethylene in total replacement hip prostheses elicits deleterious biologic reactions and may be thus a limiting factor that compromises the long-term performance of these devices. This study is based on the report of two clinical failures of total hip prostheses with metallic femoral heads and polyethylene acetabular cups. The investigations reveal that foreign bodies (titanium fibermesh pieces) can migrate into the joint space of total hip prostheses and participate in abrasive third-body wear of the polyethylene cups. This excessive wear of polyethylene enhanced by the modification of the metallic counterface roughness is likely to induce the early loosening of the devices.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1004897411765
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